Efficacy and complications of the induced membrane technique for immediate bone reconstruction in complex hand injuries

Abstract

Purpose: To report the radiological outcomes and complications of the Masquelet induced membrane technique (IMT) for acute bone reconstruction in complex hand injuries.

Methods: We retrospectively reviewed 22 patients treated primarily by the IMT for bone defect of the phalanx and/or metacarpals bones in 26 injured digits. The median bone defect length was 17 mm (IQR 13-25). Given the severity and variability of the lesions, revision parameters focused on bone healing and postoperative complications.

Results: At the median follow-up of nine months (IQR, 6-14 months), bone union was achieved in 25 digits (96%) with a median delay of three months (IQR, 2.5-3.5 months) after stage 2. Postoperative complications occurred in 11 of 26 digits requiring revision surgery in nine of 26 digits (35%). Soft tissue coverage failure and infection were the main complications. A patient underwent a late amputation through the metacarpophalangeal joint due to an uncontrolled bone infection.

Conclusions: Despite a significant rate of complications, bone reconstruction using the IMT is a reliable procedure for achieving bone healing of phalanx or metacarpal bone defects in complex hand injuries.

Keywords: Bone defect; Hand injury; Induced membrane; Masquelet technique.